CHAPTER VI
Ordinary Poisons
Unknown Poisons—Antidotes for Poisoning by Acids and Alkalies—The Stomach Pump—Emetics—Symptoms and Treatment of Metal Poisoning—Narcotics.
First Aid Rule 1.—Send at once for physician.
Rule 2.—Empty stomach with emetic.
Rule 3.—Give antidote.
In most cases of poisoning emetics and purgatives do the most good.
UNKNOWN POISONS.—Act at once before making inquiry or investigation.
First Aid Rule.—Give two teaspoonfuls of chalk (or whiting, or whitewash scraped from the wall or a fence) mixed with a wineglass of water. Beat four eggs in a glass of milk, add a tablespoonful of whisky, and give at once.
Meanwhile, turn to p. [186], and be prepared to follow Rule 2 under Suffocation, in case artificial respiration may be necessary, in spite of the stimulant and antidotes. After having taken the first steps, try to ascertain the exact poison used, but waste no time at the start. If you can find out just what poison was swallowed, give the treatment advised under that poison, excepting what you may already have given.
ACIDS.—Symptoms: Corrosion or bleeding of the parts with which they come in contact, followed by intense pain, and then prostration from shock. Nitric acid stains face yellow; sulphuric blackens; carbolic whitens the mucous membrane, and also causes nausea and stupor.
Treatment.—Carbolic: Give a tablespoonful of alcohol or wineglass of whisky or brandy at once; or one tablespoonful of castor oil, also a half pint of sweet oil, also a pint of milk. Put to bed, and apply hot-water bottles.
Nitric and Oxalic: Chalk, lime off walls, whitewash scraped off fence or wall, one teaspoonful mixed with a quarter of a glass of water. Give one tablespoonful castor oil, and half a pint of sweet oil. Inject into the rectum one tablespoonful of whisky in two of water.
Sulphuric: Soapsuds, half a glass; a pint of milk.
Other Acids: Limewater, or two teaspoonfuls of aromatic spirit of ammonia diluted with a glass of water. One tablespoonful of castor oil.
ALKALIES.—Symptoms: Burning and destruction of the mucous membrane of mouth, severe pain, vomiting and purging of bloody matter, rapid death by shock.
Ammonia; Potash; Lye; Caustic Soda; Washing Soda: Give half a glass of vinegar mixed with half a glass of water; also juice of four lemons in two glasses of water. One teaspoonful of castor oil in half a glass of olive oil. If prostrated, give tablespoonful of whisky in a quarter of a glass of hot water.
METALS.—Symptoms: Great irritation, cramps and purging, suppression of urine, delirium or stupor, collapse, and generally death.
Arsenic; Paris Green; Fowler's Solution; "Rough on Rats": Intense pain, thirst, griping in bowels, vomiting and bloody purging, shock, delirium. Patient picks at the nose. Send to druggist's for two ounces hydrated sesquioxide of iron, the best antidote, and give tablespoonful every quarter hour in half a glass of water. Meanwhile, or if antidote is not to be had, give a glass or two of limewater, followed by a teaspoonful of mustard dissolved in a glass of water, followed by warm water in any quantity.
Copper; Blue Vitriol; Verdigris: Give one tablespoonful of mustard in a glass of warm water. After vomiting, give whites of three eggs, one pint of milk.
Mercury; Corrosive Sublimate; Bug Poison; White Precipitate; Bichloride of Mercury: Give whites of four eggs for every grain of mercury suspected; cause vomiting by giving a tablespoonful of mustard mixed with a glass of warm water, or thirty grains of powdered ipecac mixed with half a glass of water.
Silver Nitrate: Give two teaspoonfuls of table salt dissolved in two glasses of hot water. After half an hour give a tablespoonful of castor oil.
Phosphorous; Matches: Give teaspoonful of mustard mixed in a glass of water. After vomiting has occurred, give a tablespoonful of gum arabic dissolved in a tumblerful of hot water. An hour later give tablespoonful of Epsom salts dissolved in a glass of water. Give no oil.
Antimony; Tartar Emetic: Symptoms as stated for metals. Give thirty grains of powdered ipecac stirred in wineglass of water, even if vomiting has occurred. Give three cups of strong tea, or hot infusion of oak bark, and two teaspoonfuls of whisky in wineglass of hot water. Use hot-water bottles to keep patient warm.
NARCOTICS.—Aconite; Belladonna; Camphor; Digitalis; Ergot; Hellebore; Lobelia: These all cause nausea, numbness, stupor, rapidity of the heart followed by weakness of heart, delirium or convulsions, coma, and death. There is often an acid taste in mouth, with dryness of throat and mouth, fever, vomiting and diarrhea, with severe pain in the bowels. Pupils are dilated.
In either case use the stomach pump at once. If no pump is at hand, siphon out stomach with rubber tube and funnel. If tube is not available, give thirty grains of powdered ipecac stirred in a wineglass of water, followed by two glasses of warm water. As the patient vomits, give more warm water. When vomiting ceases, give two cups of strong hot coffee, and then a tablespoonful of castor oil.
Keep patient awake by rubbing; do not exhaust him by walking him about. He must lie flat. If prostration follows, give two teaspoonfuls of whisky in wineglass of hot water from time to time, if repetition is necessary.
Alcohol; Liquors Containing It: Symptoms of drunkenness, stupor, drowsiness, irritability of temper, rapid, weak heart, sleep, coma. Breath testifies.
If possible, use stomach pump early, or tube and funnel. Or give thirty grains of powdered ipecac stirred in a wineglass of water, and when vomiting ceases give thirty drops of aromatic spirit of ammonia in a wineglass of water every half hour till pulse has become full and rapid. Then apply cold to the head and heat to the extremities.
Chloral; Patent Sleeping Medicines; "Knock-out Drops." Symptoms: Nausea, coldness and numbness, stupidity, prostration, often vomiting and purging, sleep, coma. Heart very weak, with pulse at wrist very feeble. Constriction of the mouth and throat, with dryness. Pain in bowels is marked before stupor appears.
Use stomach pump if possible, or empty stomach with rubber tube and funnel, siphoning fluids out. Or give thirty grains of powdered ipecac stirred in a wineglass of water. When vomiting ceases, give two teaspoonfuls of whisky in half a glass of hot water. Give hypodermic injection of sulphate of strychnine, one-twentieth of a grain every two or three hours, till patient is roused and weakness is past. Rubbing of the surface, application of hot-water bottles to the body and legs.
If breathing ceases, follow Rule 2 under Suffocation (p. [186]) till breathing is well established again.
Opium; Morphine; Laudanum; Paregoric; Soothing Syrups. Symptoms: Drowsiness, sleep, stupor when roused, pupils very small—"pin point" unless patient is used to the drug—constipation, cold skin.
Use stomach pump, if at hand. Or give emetic of thirty grains of powdered ipecac stirred in a wineglass of water, followed by two glasses of warm water, as vomiting proceeds. Let the patient inhale ammonia or smelling salts. Give him half a grain of permanganate of potash dissolved in a wineglass of water, every half hour. Inject two ounces of black coffee, at blood heat, into the rectum.
Rub the lower part of the body and legs briskly toward the heart, while artificial respiration is being carried out. See Rule 2 under Suffocation (p. [186]). Thirty drops of tincture of belladonna to an adult, every hour, will assist the breathing. Do not exhaust the patient by walking him around, slapping him with wet towels, or striking him on the calves; keep him awake by rubbing.
Tobacco when Swallowed: Nausea and vomiting occur, with severe pain and great prostration; delirium or convulsions may follow. The heart, at first rapid and full, becomes weak and compressible.
Give emetic at once: thirty grains of powdered ipecac stirred in wineglass of water, followed by two glasses of warm water, by degrees. Give whisky, two teaspoonfuls in wineglass of hot water. Keep patient warm.
Nux Vomica; Strychnine. Symptoms: Excitement, rapid heart action, restlessness, panic of apprehension, twitching of forearms and hands, possibly convulsions, during consciousness.
Use stomach pump, if possible, or give thirty grains of powdered ipecac stirred in a wineglass of water. Then, when vomiting has ceased, give twenty grains of chloral, together with thirty grains of bromide of sodium in half a glass of water, at blood heat, injected into the rectum. Give twenty grains of bromide of sodium in a wineglass of water, every hour, by the mouth.
If convulsions, put chloroform before nose and mouth, as follows: pour twenty drops of chloroform on a handkerchief and hold it close to the mouth, letting air pass freely under it. Stop when patient relaxes. Resume if he becomes rigid again.
Cocaine. Symptoms: General nervousness, irritability of temper, wakefulness, followed quickly by great pallor, dilatation of the pupils, unconsciousness, and convulsions.
Give the patient two teaspoonfuls of whisky in a wineglass of water every hour. Give, if possible, a hypodermic of a thirtieth of a grain of strychnine, every two hours, or as he may require it, to keep the pulse full and strong. Use hot-water bottles to feet and legs.
Phenacetin; Acetanilid; Headache Powders: Give two teaspoonfuls of whisky in a wineglass of hot water. If the heart flags, give tincture of digitalis, five minims in tablespoonful of water, every two hours, or till three doses are given. It is better to use digitalin, one one-hundredth of a grain hypodermically, if possible.